Can I Supplement with Formula and Still Breastfeed?

Just like a birth plan, sometimes, breastfeeding does not go to plan and some moms may need to supplement.  This does not have to mean the beginning of the end of breastfeeding if caution is used in how you supplement.

Supplementing Baby at the Breast

Often supplementation is only necessary for a short term while mom is regaining her milk supply or baby is having a frenotomy to release a tethered tongue to facilitate milk transfer. And the best method for supplementing formula is doing so while keeping the baby at the breast.  However, Supplemental Nutrition Systems are often expensive and difficult to clean so short-term feeding tubes are the preferred method in these cases.  In the case of supplementing a newborn, the best option is a 5FR feeding tube that is 36" long.  Don't opt for a shorter tube such as 15" because the shorter the tube, the faster the flow of milk and babies need to latch and use their tongue and jaw just as they would when exclusively breastfeeding. The act of the baby sucking at the breast while being supplemented also increased mom's milk supply.  

Lactation Aid Feeding Tube

You can use the feeding tube by placing the large end in a container and taping the other end of the tubing to the breast with the tube slightly past the nipple since the nipple will elongate during the feeding. You can use a 50ml cap as shown above or just a bottle and nipple by enlarging the hole in the nipple for this use only.  

Positioning Tubing on Nipple

Use medical grade tape such as transpore tape or micropore tape. Micropore tape has been found to be slightly more gentle on dry skin.  Image above shows tape on the areola, but you may prefer to start the tape the an inch behind the nipple to keep it secure and out of the infant's mouth. Either way it is best to run the tape in the same direction as the feeding tube 

Micropore Medical Tape

Lactation Aid Feeding Tube Sets can be purchased with tubing, containers, caps and syringes for flushing the tube as well. As I mentioned earlier, this is a short term feeding system so discontinue using the tube if it becomes rigid on the end or after two weeks of use, whichever comes first.

Lactation Aid Feeding Tube Set

Remember that your goal in short-term supplementing formula is to provide any shortage of nutrition to your baby.  So don't supplement the full amount of a feed if your body is making milk.  Only supplement the difference in formula.  This amount should be decreasing as your body begins to increase in milk supply.  In addition to keeping the baby at the breast to further hinder your supply, you will want to take a galactagogue lactation supplement to help you increase supply more quickly.  This way the time necessary for supplement is shortened.  

Best wishes for short-term supplementation and long-term breastfeeding!

Tanya

Get the Most of of Pumping with the Correct Breast Shield Flange Size

 

Every mom wants to get the most out of the time she spending pumping!  One of the best ways to make sure your pump is effective is to ensure your breast shield flange size is optimal.  An optimal fit engages the milk sinuses by compressing the areola the right way without causing nipple pain.

The infographic above shows you what to look for when you are pumping.  Most pumps including the best-selling Spectra breast pumps, include a standard flange size which is often 24mm.  Many moms find that is too large and opt for the 20mm breast flange.  And there are a few who need a larger 28mm or 32mm flange size.  But there are moms who until now had to look for another option if they needed smaller than a 20mm size.  Spectra has finally come out with a Spectra 16mm breast shield just for those moms!

In addition to using the right size flange, making sure your pump is functioning at the optimal suction level is so important.  Use your pump at the highest suction where you feel comfortable. Don't use a suction level that is uncomfortable or it will actually lessen your output because you are not relaxed.  

Opposite of having your suction at too high a level, low suction can cause less milk output as well.  This can often happen when a mother is not changing the breast pump valves and backflow protectors regularly.  These two components greatly affect your breast pump suction and therefore can greatly affect your milk supply.

So here is to comfortable, optimal pumping!

Tanya

Working & Breastfeeding: Pump up your Schedule

Planning to pump for an 8-hour workday will depend on various factors such as your work environment and breaks. However, here's a general sample pumping schedule for an 8-hour 9-5 workday and some tips to make it work for you.  Make sure to make a plan for your pumping space ahead of time so you have what you need for cleaning your parts and storing your breast milk.

7:00 AM - Nurse before you leave for work.

9:00 AM - Start of Workday:

10:00 AM - First Pumping Session: Allow at least 15 minutes for at least 10 minutes of pumping with a quality double electric breast pump and 5 minutes to set up and put up your supplies.

12:30 PM - Lunch Break: Eat before your next pumping session so that there are no more than 3 hours between emptying your breasts.  This will help ensure a healthy milk supply and offset clogged milk ducts.

1:00 PM - Second Pumping Session: 15 min (Of if you baby's child care is on your work campus, you can opt to nurse during your lunch break instead of pumping.)

4:00 PM - Third Pumping Session: 15 minutes.  If you have stored your milk in a refrigerator during the day, make sure to pack it a cooler carrier now so that it is ready to go when your work day ends.

5:00 PM - End of Workday

Remember to communicate your pumping schedule and needs with your employer and colleagues to ensure a supportive and understanding work environment. Adjust the schedule based on your individual requirements and any changes in your work day such as staff meetings. If a meeting or other work emergency prevents you from executing your plan exactly, put your next two pumping or nursing sessions closer together to protect your milk supply.  For example, if there was an emergency meeting called at 10:00 am, pump at 11 and again at 1:00.  Even if you have to put pumping sessions as close together as one hour, it is better not pump less than three times per day at work.  This should not be an every day occurrence as  you will extract less milk when pumping sessions are closer than three hours apart, but it helps to protect your breast health and your future milk supply if you keep the same number of pumping sessions even if the schedule varies.  

We don't need to remind you to prioritize your baby's well being as you have chosen to give your baby this precious part of yourself, but remember to prioritize your well-being as well.  This means you may need to purchase supplies that make it easier for you to pump at work.  The easier it is, the longer you will be able to provide this liquid gold for your baby.  For example, microwave steam sterilizer bags are a must have if you accidentally drop your pump part on the floor.  A breast pump tote bag that houses all your supplies help you consolidate for a quicker pumping session.  Buying two breast milk cooler carriers so that you can drop one at day care and have one with you is so helpful.  An breathable air-dry pump parts bag to keep your pumps clean and allows them to dry on their own after rinsing.  (Do not use a Ziplock bag which causes a greenhouse effect and can grow yeast.) And a hands-free pumping bra can allow you to work while you pump if your job is demanding.  

Best wishes for pumping up your schedule!

Tanya

DIY Lactation Aid Feeding Tube Supplemental Nursing System

If you are looking to supplement your baby at the breast due to low milk supply or other feeding difficulty, you know that traditional SNS or Supplemental Nursing Systems are expensive and hard to clean. Moms opt for at-breast supplementation because it makes getting back to breastfeeding much more likely and suckling at the breast is optimal for the infant's tooth and jaw development.  Skin to skin feeding is also a bonding experience that should not be overlooked.   

Because of the expense of SNS systems and the efforts of leading lactation experts such as Dr Jack Newman and many lactation consultants, many moms have opted to use a DIY method using 6FR or more commonly 5FR feeding tubes.

The upside to using these feeding tubes is that it is much more cost effective as an SNS or LactAid system cost is usually $50-$75.  The down side to the DIY supplemental method is that it can be messy and you have to know what you are looking for before you buy the parts to get this done. For example, it might be tempting to think a 15" feeding tube is a good thing because there is less tubing to deal with.  This is not the right size for the correct flow of breast milk.  36" feeding tubes in 5FR accurately offer a slow flow for newborns and 36" 6FR offer a medium flow for older or babies with suck difficulties.  Choosing a shorter tube increases the flow rate so we advise against it.

That is why Lactation Connection has curated a Lactation Aid Feeding Tube Starter Set for you which includes all the parts you need at a low cost of under $20.  This product includes:

    (2) 36" feeding tubes in your choice of 5FR slow flow or 6FR medium flow. 

    (1) 50ml container with (1) storage lid and (1) tubing adapter cap which allows you to use with feeding tube for gravity or anti-gravity feeding and helps prevent spills.

    (1) 30cc syringe for flushing feeding tube for cleaning

    (1) 1" x 1.5 yard roll of clear medical transpore tape which can be torn bi-directionally. This is used to tape the         securely to the breast.

As with all lactation aid feeding tubes, these are not to be used for more than two weeks and should be replaced if milk was allowed to dry in them or if the tubing begins to feel hard.  

Best wishes for nourishing your baby at the breast, 

Tanya   

Mercury Facts: Eating Tuna while Breastfeeding

Pregnant and nursing mothers need to be aware that mercury can pass to fetus and through breastmilk. Canned tuna in particular is under scrutiny. James E. Rogers, PhD, director of Food Safety Research and Testing at Consumer Reports made this statement regarding tuna, “From can to can, mercury levels can spike in unpredictable ways that might jeopardize the health of a fetus.”. The FDA states that fetuses, infants and young children are more vulnerable to the potential effects of mercury due to their small bodies, metabolism and speedy growth.

According to Thomas Hale, PHD founder of the Infant Risk Center renown for his work with how foods and medications, supplements and foods pass through breastmilk, states that "Developing fetuses, young infants and children are particularly sensitive to the toxic effects of methylmercury on the brain and nervous system. It is thus especially important that women of childbearing age, and those who are pregnant or breastfeeding, be equipped with knowledge and resources to help them make better choices regarding the seafood they choose to consume so they reap the benefits of seafood consumption without subjecting themselves to excessive methylmercury exposure.'

This does not mean nursing mothers should avoid seafood, but there are much safer choices than tuna and other large predatory fish. Large predatory fish consume many smaller fish, accumulating methylmercury in their tissues therefore the older and larger the fish, have greater potential for high mercury levels in their bodies.

Better choices in seafood for pregnant and nursing mothers include catfish, cod, shrimp, salmon and trout.  Below is a chart so you can check the FDA advice on your favorite seafood.

If canned tuna is your go-to lunch meal, you may want to try canned salmon.  Or for a non-seafood option, use canned chicken prepared as a chicken salad very much the way you prepare tuna salad.  Instead of pickles and apples traditionally used with tuna, you may want to try pineapple and almond slivers which compliment the chicken deliciously.  There are also other great combinations to add into chicken salad such as grapes and pecans.  For a third ingredient, chives or celery can also be used.  Or if you want to stick with seafood, salmon can be prepared and then shredded to use in a salmon salad sandwich instead. Ok, I'm hungry now so time to sign off.

Here is to safe consumption!

Tanya

Breastfeeding Blog: Emergency Pumping Power

A common fear for moms who rely on heavily on their breast pump is what do your do when you can't plug in your pump?  For example it seems that power outages have become increasing more common. Of course there are some great rechargeable breast pumps out there like the new Spectra Synergy Gold Rechargeable, but if you don't have a high quality rechargeable pump, you need some other way to express.

Manual expression can have a learning curve so knowing how is a great tool and the tried and true method is the Marmet Technique of manual expression.  Although I have linking it here, remember that in a power outage, you may not have access to view technique so it is good to practice before you need it.  

Did you that major breast pump brands offer conversion kits to turn your regular breast milk collection kit into a manual pump?  Spectra Manual Adapter Kit uses your current Spectra brand flange, valve and bottle to convert to an effective one-handed manual pump.  Ameda One Hand Assembly converts most Ameda breast pump kits (other than the original Mya which did not have the same shaped flange) into a manual pump.  

Other power considerations should be planned for travel such as for work or for families with babies in the NICU who spend a lot of time going to and from the hospital.  I recently spoke with a mom of a 4lb preemie whose home is an hour away from the hospital.  She was so grateful to know that there are breast pump vehicle adapters for many breast pump pump brands including the Motif Luna, Spectra S2 (which also works the Spectra Synergy Gold) and Ameda Mya Joy.

Both breast pump vehicle adapters and manual breast pumps offer you options when the unexpected comes up in your pumping journey.

Here is to being prepared!

Tanya

Must Have Breastfeeding Products for 2023

Lactation Connection will be celebrating 30 years serving nursing mothers in 2023. It is hard to believe how time flies!  When I started this business in 1993, the only quality breast pumps were the ones you had to rent and hands-free pumping bras were non-existent!

The good news is that moms today have great choices in breastfeeding products so if you are a new mom or mom-to-be, here is a list of essentials for nursing and pumping today!

1.  High Performance Breast Pump

There are quite a few good breast pumps on the market, but the most innovative are not the wearable breast pumps.  We have seen those come and go for example a company called WhisperWear.  The reason wearable pumps don't stand the test of time is that they have to operate on regular batteries which until we get a better portable power source reduce the suction as the batteries weaken so until technology catches up, you are better off with an electric breast pump that plugs in or uses a lithium ion rechargeable battery. Breast pump vehicle adapters for your car also work well because they are using your car battery as their power source.

Our favorites are the Spectra Synergy Gold and Synergy Gold Rechargeable Breast Pump.  If you are looking for a hospital grade which means it lasts longer than one baby or need it for a corporate lactation room, the Spectra S3 Pro or the Ameda Pearl breast pump are the most cost effective durable medical equipment breast pumps.

2.  Hands Free Pumping Bra Accessory

In our multi-tasking world, hands-free pumping bras are a must have.  The best ones are not necessarily a bra and holder in one, but a hands-free bra accessory such as Simple Wishes, Motif Hands-Free Pumping Bra and Bravado Clip and Pump.  The first two go over any nursing bra that is pulled down so you can wear your favorite bra and easily put on before pumping.  The Bravado Clip and pump attaches to any one hand breast pump clip for pumping.

3.  Breast Pump Tote and Cooler Bag

While it might seem like a luxury, a breast pump tote where you can keep your pump protected and ready to travel is essential especially if it has room for or has a cooler compartment included.  You will want a cooler with hard ice so that it keeps your milks cold for 8-10 hours while you are working and traveling to and from work. We have noticed moms prefer a breast pump backpack style to allow hands free. If you already have a bag to use, make sure to get a great breastmilk cooler tote that holds up to six bottles and three hard ice packs.

4. Breast Pump Parts Air Dry Bag

While a ziplock bag might be your first instinct, the realization that yeast grows in warm moist environments should deter you from using a ziplock bag to store and dry your breast pump parts between cleaning and use. Pumpin' Pal Air Dry Bag is a draw string bag, but we have found that moms prefer the zipper style from Breastmilk Bandit.  The Breastmilk Bandit Store and Dry Bag also includes a carabiner clip so you can hang to dry or attach to your breast pump carrying bag.

5.  Breast Milk Storage Bags

There are many styles of breast milk storage bags that get the job done.  Some of our favorites include the Motif Breast Milk Bag with pour spout and the Spectra Simple Store Bags with the ability to feed right out o the bag. Other popular bags include the Ameda Pump and Protect Bag as well as the original Spectra Breast Milk Storage Bags.

6.  Microwave Steam Sterilizer Bag

The microwave steam sterilizer bags are not only a must for those who have a microwave at work, but make sterilizing at home so much easier.  Just add water and pop in the microwave!  This eliminates the risk of  sterilizing on the stovetop and making your pump parts cloudy or worse yet forgetting about them and ending up with a melted mess.

7.  Extra Parts for your Breast Pump

Working moms love having extra breast pump parts so they can just dump them in their dry bag and sterilize everything at home.  We recommend having 6 breast shields and valve sets to make this easier.  Both valves and diaphragms aka backflow protectors need to be replaced every 6-8 weeks as older parts don't function as well and can reduce the suction thereby reduce milk supply.  Before you buy extras, make sure you have the correct breast flange size and if your pump brand does not have what you need, check out the Pumpin' Pal options.